In this Oct. 26, 2018, file photo Health and Human Services Secretary Alex Azar speaks about proposed reforms to Medicare Part B drug pricing policies at the Brookings Institute in Washington. The Trump administration says it is moving ahead with a plan to let patients directly receive prescription drug discounts negotiated behind-the-scenes between drugmakers, middlemen, and insurers. Azar said Thursday, Jan. 31, 2019, the proposed regulation would encourage the major industry players to channel any such discounts to consumers when they purchase their prescriptions. (AP Photo/Alex Brandon, File)